Transforming growth factor beta-1 (TGF-ß1) expression in patients with adenomyosis.

Objective: To compare Transforming growth factor beta-1 (TGF-ß1) expression in patients with and without adenomyosis. Methods: A prospective design was performed including 49 patients submitted to hysterectomy. Immunohistochemistry was performed on anatomopathological samples staged in paraffin blocks from patients with and without adenomyosis. The sample contained 28 adenomyosis cases and 21 controls. Student's t-test and multivariate logistic regression tests were used for statistical analysis. Associations were considered significant at p < 0.05. Results: We found no significant association between adenomyosis and: smoking (p = 0.75), miscarriage (p = 0.29), number of previous pregnancies (p = 0.85), curettage (p = 0.81), pelvic pain (p = 0.72) and myoma (p = 0.15). However, we did find a relationship between adenomyosis and abnormal uterine bleeding (AUB) (p = 0.02) and previous cesarean section (p = 0.02). The mean TGF-ß1 intensity (mean ± SD) in the ectopic endometrium of women with adenomyosis showed no significant association (184.17 ± 9.4 vs.184.66 ± 16.08, p = 0.86) from the topic endometrium of women without adenomyosis. Conclusion: TGF-ß1 expression was not increased in the ectopic endometrium of women with adenomyosis.

Follicular fluid concentration of soluble Human-G Leukocytic Antigen (sHLA-G) in in vitro fertilization cycles of women with and without peritoneal endometriosis.

OBJECTIVE: The objective of this research is to investigate the association between the concentrations of soluble human leukocyte G antigen (sHLA-G) in the follicular fluid (FF) in infertile patients with peritoneal endometriosis submitted to in vitro fertilization. METHODS: We performed a cross-sectional study, including ninety-six women undergoing in vitro fertilization (IVF) ageing ≤ 40 years. Infertile patients were classified into two groups: with endometriosis diagnosed by laparoscopy and without endometriosis due to tubal factor. ELISA measured soluble HLA-G in the FF of a pool of punctured (more than 17mm) follicles from women with endometriosis and without endometriosis who were subjected to ovulation induction for IVF. Embryos obtained after fertilization were classified according to the graduated embryo score (GES). RESULTS: Groups were comparables in terms of age, the number of follicles, AMH, FSH and all included reproductive outcomes. There was no association between sHLA-G concentrations and the average score of the generated embryos (p>0.05). Measurement of sHLA-G in the follicle fluid in women with endometriosis and without endometriosis (tubal factor) showed no significant difference (p>0.05). We also compared sHLA-G per follicle and per embryo, which were not different between both groups (p>0.05). CONCLUSIONS: Patients with peritoneal endometriosis submitted to IVF did not demonstrate an altered sHLA-G in the follicular fluid compared to the follicular fluid sHLA-G concentration in tubal factor patients. Also, this molecule was not linked to any other reproductive outcome.

Transforming growth factor beta-1 (TGF-β1) expression in patients with adenomyosis

Abstract Objective: To compare Transforming growth factor beta-1 (TGF-β1) expression in patients with and without adenomyosis. Methods: A prospective design was performed including 49 patients submitted to hysterectomy. Immunohistochemistry was performed on anatomopathological samples staged in paraffin blocks from patients with and without adenomyosis. The sample contained 28 adenomyosis cases and 21 controls. Student's t-test and multivariate logistic regression tests were used for statistical analysis. Associations were considered significant at p < 0.05. Results: We found no significant association between adenomyosis and: smoking (p = 0.75), miscarriage (p = 0.29), number of previous pregnancies (p = 0.85), curettage (p = 0.81), pelvic pain (p = 0.72) and myoma (p = 0.15). However, we did find a relationship between adenomyosis and abnormal uterine bleeding (AUB) (p = 0.02) and previous cesarean section (p = 0.02). The mean TGF-β1 intensity (mean ± SD) in the ectopic endometrium of women with adenomyosis showed no significant association (184.17 ± 9.4 vs.184.66 ± 16.08, p = 0.86) from the topic endometrium of women without adenomyosis. Conclusion: TGF-β1 expression was not increased in the ectopic endometrium of women with adenomyosis.

Prevalência de feminicídios na Grande Vitória envolvendo região craniofacial no período de pandemia do vírus Sars-CoV-2 / Feminicide prevalence in Grande Vitória involving the craniofacial region during the pandemic of the Sars-CoV-2 virus

Introdução: feminicídio é o homicídio que envolve violência doméstica e familiar, menosprezo ou discriminação ao fato da vítima ser mulher. Em 2020, foi decretada pandemia do vírus SARS-CoV-2 e como forma de reduzir a disseminação foi adotado o isolamento social, expondo muitas mulheres a um maior risco de violência doméstica. Estudos apontam que a maioria dos traumatismos relacionados à violência contra mulher ocorrem na face, ressaltando a importância de estudar os casos de feminicídio envolvendo a região bucomaxilofacial. Objetivo: verificar a prevalência de feminicídio, envolvendo lesões em região craniofacial, no período anterior (2018 e 2019) e durante (2020 e 2021) a pandemia da coronavírus. Métodos: foi realizada análise descritiva, por meio da frequência numérica e percentual do número de feminicídios envolvendo a região craniofacial no período de 2018 a 2021. Resultados: o número de laudos analisados de feminicídio ocorridos na Grande Vitória foi 47, sendo 24 antes e 23 durante a pandemia. Averiguou-se também que em 68,83% dos casos houve a presença de lesão craniofacial, principalmente em região do crânio e extraoral. Conclusão: não ocorreu variação significativa na prevalência de feminicídio antes e durante a pandemia do vírus SARS-CoV-2 na região da Grande Vitória, no Estado do Espírito Santo

Introduction: femicide is homicide that involves domestic and family violence, contempt or discrimination against the fact that the victim is a woman. In 2020, pandemic of SARS-CoV-2 virus was declared and, to reduce the spread of the disease, social isolation was adopted, exposing many women to a greater risk of domestic violence. Studies indicate that most traumas occur on the face, highlighting the importance of studying cases of femicide involving the oral and maxillofacial region. Purpose: to verify the prevalence of femicide, involving lesions in the craniofacial region, in the period before (2018 and 2019) and during (2020 and 2021) the coronavirus pandemic Methods: a descriptive analysis was carried out, through the numerical frequency and percentage of the number of femicides involving the craniofacial region in the period from 2018 to 2021. Results: the number of reports of femicide analyzed in Vitória was 47, with 24 before and 23 during the pandemic, with no significant variation. It was also found that in 68.83% of the total cases there was the presence of craniofacial lesion, mainly in the skull and extraoral region. Conclusion: there was no significant variation in the prevalence of femicide before and during the SARS-CoV-2 virus pandemic in the Grande Vitória region, in the state of Espírito Santo

The Graduated Embryo Score of Embryos from Infertile Women with and without Peritoneal Endometriosis.

OBJECTIVE: To determine embryo quality (mean graduated embryo score [GES]) in infertile patients with endometriosis undergoing in vitro fertilization with embryo transfer (IVF-ET) compared with infertile patients without endometriosis. METHODS: A case-control study was performed comparing 706 embryos (162 patients) divided into 2 groups: 472 embryos derived from patients without endometriosis (n = 109, infertile patients with tubal infertility) and 234 embryos from patients in the study group (n = 53, infertile patients with peritoneal endometriosis). All patients were subjected to IVF using an oestradiol-antagonist-recombinant follicle-stimulating hormone (FSH) protocol for ovarian stimulation. The mean GES was performed to evaluate all embryos at 3 points in time: 16 to 18 hours, 25 to 27 hours, and 64 to 67 hours. Embryo evaluation was performed according to the following parameters: fragmentation, nucleolar alignment, polar body apposition, blastomere number/morphology, and symmetry. The primary outcome measure was the mean GES score. We also compared fertilization, implantation, and pregnancy rates. RESULTS: Although the number of embryos transferred was greater in patients with endometriosis than in the control group (2.38 ± 0.66 versus 2.15 ± 0.54; p = 0.001), the mean GES was similar in both groups (71 ± 19.8 versus 71.9 ± 23.5; p = 0.881). Likewise, the fertilization rate was similar in all groups, being 61% in patients with endometriosis and 59% in the control group (p = 0.511). No significant differences were observed in the implantation (21% versus 22%; [p = 0.989]) and pregnancy rates (26.4% versus 28.4%; p = 0.989). CONCLUSION: Embryo quality measured by the mean GES was not influenced by peritoneal endometriosis. Likewise, the evaluated reproductive outcomes were similar between infertile patients with and without endometriosis.

OBJETIVO: Determinar a qualidade do embrião (média de escore embrionário graduado [EEG]) em pacientes inférteis com endometriose submetidas à fertilização in vitro com transferência de embrião (FIV-TE) em comparação com pacientes inférteis sem endometriose. MéTODOS: Realizamos um estudo de caso-controle comparando 706 embriões (162 pacientes) divididos em dois grupos: 472 embriões derivados de pacientes sem endometriose (n = 109, pacientes inférteis com infertilidade tubária) e 234 embriões de pacientes do grupo de estudo (n = 53, inférteis pacientes com endometriose peritoneal). Todos os pacientes foram submetidos à fertilização in vitro usando um protocolo follicle-stimulating hormone (FSH) recombinante de estradiol-antagonista para estimulação ovariana. A média do EEG foi realizada para avaliar todos os embriões em três momentos: de 16 a 18 horas, 25 a 27 horas e 64 a 67 horas. A avaliação embrionária foi realizada de acordo com os seguintes parâmetros: fragmentação, alinhamento nucleolar, aposição do corpo polar, número de blastômeros/morfologia e simetria. A medida de desfecho primário foi o escore médios embrionário (EEG). Também avaliamos como desfechos secundários as taxas de fertilização, implantação e gravidez. RESULTADOS: Embora o número de embriões transferidos tenha sido maior em pacientes com endometriose do que no grupo controle (2,38 ± 0,66 versus 2,15 ± 0,54; p = 0,001), o EEG médio foi semelhante nos dois grupos (71 ± 19,8 versus 71,9 ± 23,5; p = 0,881). Da mesma forma, a taxa de fertilização foi semelhante em todos os grupos, sendo 61% nos pacientes com endometriose e 59% no grupo controle (p = 0,511). Não foram observadas diferenças significativas nas taxas de implantação (21% versus 22%; [p = 0,989]) e nas taxas de gravidez (26,4% versus 28,4%; p = 0,989). CONCLUSãO: A qualidade embrionária medida pelo EEG médio não foi influenciada pela endometriose peritoneal. Da mesma forma, os resultados reprodutivos avaliados foram semelhantes entre pacientes inférteis com e sem endometriose.

The graduated embryo score of embryos from infertile women with and without peritoneal endometriosis / Escore embrionário graduado em embriões de mulheres inférteis com e sem endometriose peritoneal

Abstract Objective To determine embryo quality (mean graduated embryo score [GES]) in infertile patients with endometriosis undergoing in vitro fertilization with embryo transfer (IVF-ET) compared with infertile patients without endometriosis. Methods A case-control study was performed comparing 706 embryos (162 patients) divided into 2 groups: 472 embryos derived from patients without endometriosis (n= 109, infertile patients with tubal infertility) and 234 embryos from patients in the study group (n= 53, infertile patients with peritoneal endometriosis). All patients were subjected to IVF using an oestradiol-antagonist-recombinant follicle-stimulating hormone (FSH) protocol for ovarian stimulation. Themean GESwas performed to evaluate all embryos at 3 points in time: 16 to 18 hours, 25 to 27 hours, and 64 to 67 hours. Embryo evaluation was performed according to the following parameters: fragmentation, nucleolar alignment, polar body apposition, blastomere number/morphology, and symmetry. The primary outcomemeasure was the mean GES score.We also compared fertilization, implantation, and pregnancy rates. Results Although the number of embryos transferred was greater in patients with endometriosis than in the control group (2.38 ± 0.66 versus 2.15 ± 0.54; p= 0.001), the meanGESwas similar inbothgroups (71 ± 19.8 versus 71.9 ± 23.5; p= 0.881). Likewise, the fertilization ratewas similar in all groups, being 61% in patients with endometriosis and 59% in the control group (p= 0.511). No significant differences were observed in the implantation (21% versus 22%; [p= 0.989]) and pregnancy rates (26.4% versus 28.4%; p= 0.989). Conclusion Embryo quality measured by the mean GES was not influenced by peritoneal endometriosis. Likewise, the evaluated reproductive outcomes were similar between infertile patients with and without endometriosis.

Resumo Objetivo Determinar a qualidade do embrião (média de escore embrionário graduado [EEG]) em pacientes inférteis com endometriose submetidas à fertilização in vitro com transferência de embrião (FIV-TE) em comparação com pacientes inférteis sem endometriose. Métodos Realizamos um estudo de caso-controle comparando 706 embriões (162 pacientes) divididos em dois grupos: 472 embriões derivados de pacientes sem endometriose (n = 109, pacientes inférteis com infertilidade tubária) e 234 embriões de pacientes do grupo de estudo (n= 53, inférteis pacientes com endometriose peritoneal). Todos os pacientes foram submetidos à fertilização in vitro usando um protocolo follicle-stimulating hormone (FSH) recombinante de estradiol-antagonista para estimulação ovariana. A média do EEGfoi realizada para avaliar todos osembriõesemtrêsmomentos: de 16 a 18 horas, 25 a 27 horas e 64 a 67 horas.A avaliaçãoembrionária foi realizada de acordo comos seguintes parâmetros: fragmentação, alinhamento nucleolar, aposição do corpo polar, número de blastômeros/morfologia e simetria. A medida de desfecho primário foi o escore médios embrionário (EEG). Também avaliamos como desfechos secundários as taxas de fertilização, implantação e gravidez. Resultados Embora o número de embriões transferidos tenha sido maior em pacientes com endometriose do que no grupo controle (2,38 ± 0,66 versus 2,15 ± 0,54; p = 0,001), o EEGmédio foi semelhante nos dois grupos (71 ± 19,8 versus 71,9 ± 23,5; p = 0,881). Da mesma forma, a taxa de fertilização foi semelhante em todos os grupos, sendo 61% nos pacientes com endometriose e 59% no grupo controle (p = 0,511). Não foram observadas diferenças significativas nas taxas de implantação (21% versus 22%; [p = 0,989]) e nas taxas de gravidez (26,4% versus 28,4%; p = 0,989). Conclusão A qualidade embrionária medida pelo EEGmédio não foi influenciada pela endometriose peritoneal. Da mesma forma, os resultados reprodutivos avaliados foram semelhantes entre pacientes inférteis com e sem endometriose.

Randomized controlled trial comparing embryonic quality in rFSH versus hMG in the IVF protocol with GnRH Antagonist.

OBJECTIVE: The aim of the present study is to investigate embryo quality (score) after controlled ovarian stimulation for IVF using rFSH or hMG with the GnRH antagonist protocol. METHODS: Open, randomized, single center study. The patients were randomized to receive rFSH or hMG according to randomized cards inside a black envelope with the name of the respective treatment following a computer generated list (85 patients were allocated to rFSH group and 83 patients to hMG group). Inclusion criteria were patients with IVF indication and normal ovarian reserve. Embryo evaluation was performed on day three, after fertilization based on the Graduated Embryo Score (GES). RESULTS: There were no relevant differences in demographic characteristics. There was no difference in pregnancy rates with 27 (31%) and 25 (30.1%) pregnancies for rFSH and hMG, respectively (p=0.87). The total embryo score was the same for both groups, but the best embryo score was significant higher for the rFSH group (77.33±34.0 x 65.07±33.2 p=0.03). The total number of embryos was statistical different, also in favor of the rFSH group (4.17±3.1 x 3.26±2.4 p=0.04). CONCLUSION: The total embryo score was the same for both groups, but the best embryo score was significantly higher for the rFSH group. Moreover, rFSH was associated with an increased number of embryos.

PIWIL2 is overexpressed in adenomyotic lesions of women with diffuse adenomyosis.

PURPOSE: Adenomyosis has been studied throughout the years, however, its aetiology and physiopathology are still unknown. The aim of this study was to identify the presence of PIWI proteins in women with adenomyosis. METHODS: We included 72 participants to be part of this study and were divided into two groups based on their anatomopathological diagnosis, control (n = 36) or adenomyosis (n = 36). All samples were tested for PIWIL1, PIWIL2 and PIWIL4 proteins by immunohistochemistry. The evaluation of protein expression was performed by the digital histological score (DHSCORE) and by the pathologist's analysis. RESULTS: The participants had a mean age of 44.28 ± 5.76 years and 45.81 ± 4.86 years in the control and adenomyosis groups, respectively (p ≥ 0.05). Other clinical characteristics of the participants showed no statistical difference as well. PIWIL2 is highly expressed in the adenomyosis in comparison to the control group (p = 0.0001). The PIWIL1 is downregulated in the adenomyosis (p = 0.003) and PIWIL4 showed no difference in its expression (p = 0.05). CONCLUSION: PIWIL2 might be involved in cellular survival and PIWIL1 may be downregulated due to the loss of tissue's function and response to the hostile environment of the myometrium. This is the first time that PIWI proteins are studied in the adenomyosis.

The accuracy of the Montenegro skin test for leishmaniasis in PCR-negative patients.

INTRODUCTION: As highly specific molecular biology-based techniques may not be sensitive enough for the diagnosis of American tegumentary leishmaniasis (ATL), clinicians frequently rely on immunological tests before treatment initiation. Hence, the correct combination of diagnostic tests is imperative for ATL diagnosis. We aimed to evaluate the accuracy of the Montenegro (Leishmanin) skin test (MST) in polymerase chain reaction (PCR)-negative patients to accurately detect ATL. METHODS: Patients with a clinical picture compatible with ATL were divided into ATL (confirmed by lesion smear, culture indirect immunofluorescence, and/or histopathology) and no-ATL (diseases that can mimic leishmaniasis) groups. Conventional PCR for the minicircle kDNA of Leishmania was performed, and the MST was carried out for PCR-negative patients. RESULTS: Ninety-nine patients were included in this study, including 79 diagnosed with ATL (6 with mucocutaneous leishmaniasis) and 20 without ATL (no-ATL group). The MST showed a high sensitivity of 90.0% (95% confidence interval [CI] = 69.90-97.21) in PCR-negative patients that was 10% higher than the sensitivity reported in PCR-positive population (79.66%; 95% CI = 67.73-87.96). CONCLUSIONS: One of the most important reasons for PCR negativity among patients with active ATL is the presence of a strong cellular immunological response, especially in chronic and mucocutaneous leishmaniasis. This reinforces the considerable utility of the tests that detect cellular responses against Leishmania antigens such as the MST in PCR-negative patients when the performance in screening situations is questionable.

The accuracy of the Montenegro skin test for leishmaniasis in PCR-negative patients

Abstract INTRODUCTION: As highly specific molecular biology-based techniques may not be sensitive enough for the diagnosis of American tegumentary leishmaniasis (ATL), clinicians frequently rely on immunological tests before treatment initiation. Hence, the correct combination of diagnostic tests is imperative for ATL diagnosis. We aimed to evaluate the accuracy of the Montenegro (Leishmanin) skin test (MST) in polymerase chain reaction (PCR)-negative patients to accurately detect ATL. METHODS: Patients with a clinical picture compatible with ATL were divided into ATL (confirmed by lesion smear, culture indirect immunofluorescence, and/or histopathology) and no-ATL (diseases that can mimic leishmaniasis) groups. Conventional PCR for the minicircle kDNA of Leishmania was performed, and the MST was carried out for PCR-negative patients. RESULTS: Ninety-nine patients were included in this study, including 79 diagnosed with ATL (6 with mucocutaneous leishmaniasis) and 20 without ATL (no-ATL group). The MST showed a high sensitivity of 90.0% (95% confidence interval [CI] = 69.90-97.21) in PCR-negative patients that was 10% higher than the sensitivity reported in PCR-positive population (79.66%; 95% CI = 67.73-87.96). CONCLUSIONS: One of the most important reasons for PCR negativity among patients with active ATL is the presence of a strong cellular immunological response, especially in chronic and mucocutaneous leishmaniasis. This reinforces the considerable utility of the tests that detect cellular responses against Leishmania antigens such as the MST in PCR-negative patients when the performance in screening situations is questionable.

Duplicidad de la vena renal derecha en Didelphis aurita (Didelphimorphia: Didelphidae): reporte de un caso / Double right renal vein in Didelphis aurita (Didelphimorphia: Didelphidae): case report

El Didelphis aurita, conocido como comadreja de orejas negras, es un marsupial con amplia distribución en la América del Sur, frecuente tanto en los ambientes silvestres como antrópicos debido a su gran plasticidad ecológica. Animales de esta especie son comúnmente atendidos en la medicina de animales silvestres y vienen siendo empleados como modelos experimentales alternativos a especies tradicionales. El objetivo de ese trabajo fue relatar la ocurrencia de un caso de vena renal doble en un espécimen adulto, macho, de D. aurita. Para eso, se ha disecado un cadáver fijado y conservado en solución de formaldehído 10%, previamente inyectado con látex de color azul por la porción torácica de la arteria aorta para facilitar la disección. El espécimen poseía dos venas renales derechas, una vena craneal (11,3 mm) y otra caudal (10,0 mm) que drenaban distintamente para una vena cava caudal. La vena renal izquierda y las arterias renales eran únicas. Aunque la duplicidad de la vena renal es reportada en otras especies como perros, gatos y felideos silvestres, este es el primer relato en el género Didelphis. El conocimiento de las variaciones anatómicas vasculares es relevante para la correcta ejecución de procedimientos veterinarios y en la interpretación de hallazgos experimentales en relación con el sistema urogenital.

Didelphis aurita, known as black eared oposum, is a marsupial widely distributed in South America, frequently seen in both wild and anthropogenic environments due to its great ecological plasticity. This species is commonly treated in wildlife veterinary services and has been used as alternative experimental models instead of conventional species. The aim of this report was to describe a case of double renal vein in a male, adult, specimen of D. aurita. In order to make the dissection easier, the cadaver was fixed and preserved in 10 % formaldehyde solution, and previously injected with latex in blue color by the thoracic aorta to facilitate dissection. The specimen had two right renal veins, one cranial (11.3 mm) and other caudal (10.0 mm) that drained distinctly for caudal vena cava. The left renal vein and the renal arteries were single. Although double renal vein has been reported in other species, such as dogs, cats and wild felids, this is the first mention in the genus Didelphis. The knowledge of the vascular anatomical variations is relevant for the correct execution of veterinary procedures and the interpretation of experimental findings in urogenital system research.

Endometriosis-associated infertility: GDF-9, AMH, and AMHR2 genes polymorphisms.

PURPOSE: The purpose of this paper is to determine whether there is a correlation between polymorphisms in the growth differentiation factor-9 (GDF-9) gene and anti-Müllerian hormone (AMH) gene and its receptor, AMHR2, and endometriosis-associated infertility. METHODS: This is a case-control study to evaluate whether there is a correlation between polymorphisms in the GDF-9 gene (SNPs determined by direct sequencing), AMH gene, AMHR2 (both SNPs determined by genotyping using TaqMan Allelic Discrimination), and endometriosis-associated infertility. The study included 74 infertile women with endometriosis and 70 fertile women (tubal ligation) as a control group. RESULTS: Patient age and the mean FSH levels were similar between the infertile with endometriosis and fertile without endometriosis groups. The frequency of genotypes between the groups for GDF-9 gene polymorphisms did not show statistical significance, nor did the AMHR2 gene polymorphism. However, the AMH gene polymorphism did show statistical significance, relating the polymorphic allele with infertility in endometriosis. CONCLUSIONS: We demonstrate that an SNP in the AMH gene is associated with infertility in endometriosis, whereas several SNPs in the GDF-9 gene and the - 482A G SNP in the AMHR2 gene were found to be unrelated.

Homicídios e agressões: as faces mais evidentes da violência / Homicides and aggressions: The most highlighted faces of the violence

Este capítulo contém a análise da produção brasileira da área da saúde sobre homicídios/agressões publicada em artigos, dissertações e teses, no período de 2001-2013. Os fenômenos aqui tratados são sócio-históricos e se concretizam nas relações interpessoais por meio de uma agressão intencional, que utiliza diversos meios para provocar lesões e morte em outrem. Eles se configuram como uma expressão da violência e aparecem nos indicadores de saúde como causa da morbidade e mortalidade e mortalidade específicas.

Problema crônico de coluna e diagnóstico de distúrbios osteomusculares relacionados ao trabalho (DORT) autorreferidos no Brasil: pesquisa nacional de saúde, 2013 / Chronic back complaints and diagnosis of self-reported work-related musculoskeletal disorders (WMSDs) in Brazil: national health survey, 2013 / Problema crónico de la columna y diagnóstico de los trastornos musculoesqueléticos relacionados al trabajo (TMERT) autorreferidos en Brasil: encuesta nacional de salud, 2013

OBJETIVO: Descrever a prevalência de problemas crônicos de coluna e de distúrbios osteomusculares relacionados ao trabalho (DORT) autorreferidos em adultos brasileiros, segundo variáveis sociodemográficas. MÉTODOS: estudo descritivo com 60.202 indivíduos ≥18 anos incluídos na Pesquisa Nacional de Saúde 2013; foram estimadas prevalências e intervalos de confiança (IC95 por cento). RESULTADOS: a prevalência de problema crônico de coluna foi de 18,5 por cento (IC95 por cento: 17,8-19,1), maior em mulheres (21,1 por cento; IC95 por cento: 20,2-21,9), indivíduos com baixa escolaridade (24,6 por cento; IC95 por cento: 23,5-25,6) e residentes na região Sul (23,3 por cento; IC95 por cento: 21,6-25,1); dos que referiram problema de coluna, 16,4 por cento (IC95 por cento: 15,2-17,6) relataram possuir grau intenso/muito intenso de limitações nas atividades habituais, principalmente na área rural (20,3 por cento; IC95 por cento: 17,5-23,0); a prevalência de DORT foi de 2,4 por cento (IC95 por cento: 2,2-2,7), superior entre mulheres (3,3 por cento; IC95 por cento: 2,9-3,7) e indivíduos com Ensino Superior (3,8; IC95 por cento: 3,0-4,7), e mais baixa no Norte (0,7 por cento; IC95 por cento: 0,5-1,0). CONCLUSÃO: a prevalência de problema crônico de coluna foi elevada mas a prevalência de DORT, baixa, possivelmente indicando falta deste diagnóstico.

OBJECTIVE: To describe the prevalence of self-reported chronic spine complaints and work-related musculoskeletal disorders (WMSDs) in Brazilian adults, according to sociodemographic variables. METHODS: this was a descriptive study using National Health Survey data (2013) on 60,202 adults. Prevalence rates and confidence intervals (95 por cento CI) were estimated. RESULTS: 18.5 per cent of adults reported chronic spine complaints (95 per cent CI:17.8-19.1); complaints were higher among women (21.1 per cent; 95 per cent CI:20.2-21.9), individuals with less schooling (24.6 per cent; 95 per cent CI:23.5-25.6), and those resident in Southern Brazil (23,3 per cent; 95 per cent CI: 21.6-25.1). 16.4 per cent (95 per cent CI: 15.2-17.6) of those reporting spine complaints stated having a high/very high degree of limitations in performing everyday activities, especially in rural areas (20.3 per cent; 95 per cent CI:17.5-23.0). WMSDs were reported by 2.4 per cent of adults (95 per cent CI:2.2-2.7) and were higher in women (3.3 per cent; 95 per cent CI:2.9-3.7) and individuals with university level education (3.8 per cent; 95 per cent CI:3.0-4.7), while lower prevalence was observed in Northern Brazil (0.7 per cent; 95 per cent CI:0.5-1.0). CONCLUSION: chronic spine complaint prevalence was high; although WMSD prevalence was low, possibly indicating lack of diagnosis of this condition.

OBJETIVO: Describir la prevalencia de problemas crónicos de la columna vertebral y trastornos musculoesqueléticos relacionados con el trabajo (TMERT) autorreferidos en adultos de Brasil, según variables sociodemográficas. MÉTODOS: estudio descriptivo con 60.202 individuos ≥18 años incluidos en la Encuesta Nacional de Salud 2013; se estimaron prevalencias e intervalos de confianza (IC95 por ciento). RESULTADOS: Del total de la muestra, un 18,5 por ciento (IC95 por ciento: 17,8-19,1) tiene problemas crónicos en la columna vertebral. Con mayor prevalencia en mujeres (21,1 por ciento; IC95 por ciento: 20,2-21,9), individuos con bajo nivel de escolaridad (24,6 por ciento; IC95 por ciento: 23,5-25,6) y residentes en la región Sur (23,3 por ciento; IC95 por ciento: 21,6-25,1). Un 16,4 por ciento (IC95 por ciento: 15,2-17,6) informó un grado de limitación en las actividades de la vida diaria intenso o muy intenso, siendo mayor en el área rural (20,3 por ciento; IC95 por ciento: 17,5-23,0). Los TME se informaron en un 2,4 por ciento (IC95 por ciento: 2,2-2,7), más en mujeres (3,3 por ciento; IC95 por ciento: 2,9-3,7), individuos con educación superior (3,8 por ciento; IC95 por ciento: 3,0-4,7) y menos en el Norte (0,7 por ciento; IC95 por ciento: 0,5-1,0). CONCLUSIÓN: la prevalencia de problemas crónicos de la columna vertebral fue alta, pero la de TME fue baja, lo que, posiblemente, indica la falta de diagnóstico de esta enfermedad.

LH (Trp8Arg/Ile15Thr), LHR (insLQ) and FSHR (Asn680Ser) polymorphisms genotypic prevalence in women with endometriosis and infertility.

PURPOSE: To verify if polymorphisms of LH (Trp8Arg/Ile15Thr), LH receptor (insLQ), and FSH receptor (Asn680Ser) are associated with endometriosis and infertility. METHODS: This is a prospective case-control study. Sixty-seven patients with endometriosis and infertility (study group) and 65 healthy fertile patients (control group) were enrolled in the study between July 2010 and July 2013. All patients had their endometriosis diagnosis made or excluded by laparoscopic surgery; study group was submitted to the surgery for infertility investigation and control group for tubal ligation. Day-3 serum hormones were collected from all patients. Analysis of nucleotide mutations for LH polymorphisms (Trp8Arg and Ile15Thr), LHR polymorphism (insLQ), and FSHR polymorphism (Asn680Ser) were performed by PCR. RESULTS: Day-3 FSH, estradiol and LH serum levels were not different between the groups, while CA-125 was higher in patients with endometriosis and infertility. All polymorphisms studied were in Hardy-Weinberg equilibrium. The prevalence of insLQ was significantly higher in patients with endometriosis and infertility (P = 0.005). Allele occurrence in control group was 0.10 versus 0.25 in infertile endometriosis group (P = 0.001). There was no difference regarding Trp8Arg/Ile15Thr (P > 0.05) and Asn680Ser (P > 0.05) prevalence between groups. CONCLUSION: This is the first time that prevalence of insLQ was shown to be higher in patients with endometriosis and infertility than in healthy fertile patients. There was no difference in LH and FSHR polymorphisms' prevalence between groups.

Dopamine receptor D2 genotype (3438) is associated with moderate/severe endometriosis in infertile women in Brazil.

OBJECTIVE: To compare the prevalence of dopamine receptor D2 polymorphisms in patients with peritoneal endometriosis and in healthy control subjects. DESIGN: Case-control study. SETTING: University hospital. PATIENT(S): One hundred seven women aged ≥18 years who were enrolled when seeking care for infertility caused by peritoneal endometriosis or for tubal ligation. INTERVENTION(S): We performed DNA extraction of peripheral blood, followed by polymerase chain reaction to confirm single-strand polymorphisms and to sequence two polymorphisms. MAIN OUTCOME MEASURE(S): We sequenced two polymorphisms in exon 7 of the dopamine receptor D2 (DRD2) gene. Polymorphism 1 occurs in nucleotide 3420 (cytosine to thymine, 313 histidine), and polymorphism 2 occurs in nucleotide 3438 (cytosine to thymine, 319 proline). RESULT(S): The frequency of the DRD2 polymorphism 2 was increased in subjects with peritoneal moderate/severe endometriosis. Analysis of the DRD2 genotypes demonstrates an odds ratio of 2.98 (95% confidence interval 1.47-6.04) for polymorphism 2 in peritoneal moderate/severe endometriosis. CONCLUSION(S): Our results revealed that an excess of DRD2 polymorphism 2 was found in exon 7 in women with peritoneal moderate/severe endometriosis. The presence of polymorphism 2 could cause a defect in a post-receptor signaling mechanism, resulting in a mild increase in serum prolactin levels. Thus, the potential angiogenic role of prolactin may play a role in the implantation of ectopic endometriosis tissue.

ESR1 rs9340799 is associated with endometriosis-related infertility and in vitro fertilization failure.

Estrogen receptor alpha has a central role in human fertility by regulating estrogen action in all human reproductive tissues. Leukemia inhibitory factor (LIF) expression, a cytokine critical for blastocyst implantation, is mediated by estrogen signaling, so we hypothesized that ESR1 gene polymorphisms might be candidate risk markers for endometriosis-related infertility and in vitro fertilization (IVF) failure. We included 98 infertile women with endometriosis, 115 infertile women with at least one IVF failure and also 134 fertile women as controls. TaqMan SNP assays were used for genotyping LIF (rs929271), MDM2 (rs2279744), MDM4 (rs1563828), USP7 (rs1529916), and ESR1 (rs9340799 and rs2234693) polymorphisms. The SNP ESR1 rs9340799 was associated with endometriosis-related infertility (P < 0.001) and also with IVF failure (P = 0.018). After controlling for age, infertile women with ESR1 rs9340799 GG genotype presented 4-fold increased risk of endometriosis (OR 4.67, 95% CI 1.84-11.83, P = 0.001) and 3-fold increased risk of IVF failure (OR 3.33, 95% CI 1.38-8.03, P = 0.007). Our results demonstrate an association between ESR1 rs9340799 polymorphism and infertile women with endometriosis and also with women who were submitted to IVF procedures and had no blastocyst implantation.

De Kant a Mouffe: Desenvolvendo argumentos positivos acerca do reconhecimento de "famílias homoafetivas" pelo judiciário brasileiro / From Kant to Mouffe: developing positive arguments about the recognition of " families homoafetivas by the brazilian judiciary

A proposta deste artigo é desenvolver uma argumentação positiva acerca do reconhecimento, como ente familiar, de casais formados por pessoas do mesmo sexo (as chamadas relações homoafetivas), partindo dos julgados do STF. O reconhecimento de direitos e a construção de sujeitos politicamente definidos podem revelar o perigo de normatizar a sexualidade e, nesse sentido, pulverizar parte das possibilidades de vivências e arranjos sociais, quando se reafirma uma homossexualidade assentada nos padrões heteronormativos: familiar, monogâmica, afetiva. Neste sentido, ao lado dos argumentos conservadores, que não estendem aos casais homossexuais o direito de constituir famílias, soma-se uma crítica cujo principal esteio é a percepção de que normas jurídicas podem limitar a possibilidade de sexualidades libertárias. A hipótese do artigo é mostrar que estas duas visões podem ser superadas sob a perspectiva tanto da filosofia kantiana quanto da Teoria do Discurso desenvolvida no final do século XX por Ernesto Laclau e Chantal Mouffe.(AU)

The purpose of this paper is to develop a positive argument about the recognition as family, couples including same sex (called relationships homoafetivas), starting from STF. The recognition of rights and the construction of politically defined subject can reveal the danger of regulating sexuality and, in this sense, spraying part of the experiences and social arrangements, when it reaffirms a seated homosexuality heteronormative standards: family, monogamous, affectionate. In this sense, the conservative side of the arguments, which do not extend to gay couples the right to form families, adds to a critique whose mainstay is the perception that legal rules may limit the possibility of libertarian sexuality. The hypothesis of this paper is to show that these two views can be overcome both the perspective of Kantian philosophy as the Discourse Theory developed in the late twentieth century by Ernesto Laclau and Chantal Mouffe.(AU)

El propósito de este trabajo es desarrollar un argumento sobre el reconocimiento positivo como familia, pareja incluida mismo sexo (relaciones llamadas homoafetivas) a partir de Magistrados de la Corte Suprema de Justicia. El reconocimiento de los derechos y la construcción del sujeto político definido puede revelar el peligro de la regulación de la sexualidad y, en este sentido, la pulverización parte de las posibilidades de experiencias y acuerdos sociales, cuando se reafirma en estándares homosexualidad sentados heteronormativos: familia, monógamas, cariñoso. En este sentido, el lado conservador de los argumentos, que no se extienden a las parejas homosexuales el derecho a formar una familia, se suma a una crítica cuyo pilar es la percepción de que las normas jurídicas pueden limitar la posibilidad de la sexualidad libertaria. La hipótesis de este trabajo es mostrar que estos dos puntos de vista pueden ser superados tanto en la perspectiva de la filosofía kantiana como la teoría del discurso desarrollado en el siglo XX por Ernesto Laclau y Chantal Mouffe(AU)

De Kant a Mouffe: Desenvolvendo argumentos positivos acerca do reconhecimento "famílias homoafetivas" pelo judiciário brasileiro / From Kant to Mouffe: developing positive arguments about the recognition of "families homoafetivas" by the brazilian judiciary

A proposta deste artigo é desenvolver uma argumentação positiva acerca do reconhecimento, como ente familiar, de casais formados por pessoas do mesmo sexo (as chamadas relações homoafetivas), partindo dos julgados do STF. O reconhecimento de direitos e a construção de sujeitos politicamente definidos podem revelar o perigo de normatizar a sexualidade e, nesse sentido, pulverizar parte das possibilidades de vivências e arranjos sociais, quando se reafirma uma homossexualidade assentada nos padrões heteronormativos: familiar, monogâmica, afetiva. Neste sentido, ao lado dos argumentos conservadores, que não estendem aos casais homossexuais o direito de constituir famílias, soma-se uma crítica cujo principal esteio é a percepção de que normas jurídicas podem limitar a possibilidade de sexualidades libertárias. A hipótese do artigo é mostrar que estas duas visões podem ser superadas sob a perspectiva tanto da filosofia kantiana quanto da Teoria do Discurso desenvolvida no final do século XX por Ernesto Laclau e Chantal Mouffe.(AU)

The purpose of this paper is to develop a positive argument about the recognition as family, couples including same sex (called relationships homoafetivas), starting from STF. The recognition of rights and the construction of politically defined subject can reveal the danger of regulating sexuality and, in this sense, spraying part of the experiences and social arrangements, when it reaffirms a seated homosexuality heteronormative standards: family, monogamous, affectionate. In this sense, the conservative side of the arguments, which do not extend to gay couples the right to form families, adds to a critique whose mainstay is the perception that legal rules may limit the possibility of libertarian sexuality. The hypothesis of this paper is to show that these two views can be overcome both the perspective of Kantian philosophy as the Discourse Theory developed in the late twentieth century by Ernesto Laclau and Chantal Mouffe.(AU)

El propósito de este trabajo es desarrollar un argumento sobre el reconocimiento positivo como familia, pareja incluida mismo sexo (relaciones llamadas homoafetivas) a partir de Magistrados de la Corte Suprema de Justicia. El reconocimiento de los derechos y la construcción del sujeto político definido puede revelar el peligro de la regulación de la sexualidad y, en este sentido, la pulverización parte de las posibilidades de experiencias y acuerdos sociales, cuando se reafirma en estándares homosexualidad sentados heteronormativos: familia, monógamas, cariñoso. En este sentido, el lado conservador de los argumentos, que no se extienden a las parejas homosexuales el derecho a formar una familia, se suma a una crítica cuyo pilar es la percepción de que las normas jurídicas pueden limitar la posibilidad de la sexualidad libertaria. La hipótesis de este trabajo es mostrar que estos dos puntos de vista pueden ser superados tanto en la perspectiva de la filosofía kantiana como la teoría del discurso desarrollado en el siglo XX por Ernesto Laclau y Chantal Mouffe(AU)

Office hysteroscopy study in consecutive miscarriage patients.

OBJECTIVE: To assess the prevalence of uterine anatomical abnormalities found by office diagnostic hysteroscopy in a population of patients experiencing more than two consecutive miscarriages and compare the prevalence of uterine abnormalities between patients with two miscarriages and those with three or more consecutive miscarriages. METHODS: A cross-sectional study of 66 patients with two or more consecutive miscarriages diagnosis was conducted. Patients were divided into two groups: Group A (up to two miscarriages, 23 patients), and Group B (3 miscarriages, 43 patients). They underwent an outpatient diagnostic hysteroscopy study, with either congenital or acquired abnormalities of the uterine cavity being identified. RESULTS: Uterine changes were found in 22 (33.3%) patients, with 9 cases of congenital changes [arcuate uterus (4 cases), septate uterus (2 cases), and bicornuate uterus (1 case)], and 13 patients with acquired changes [intrauterine adhesions (7 cases), endometrial polyp (4 cases), and uterine leiomyoma (2 cases)]. No significant differences were found between the groups as regarding both acquired and congenital uterine changes. A positive correlation was found between anatomical changes on hysteroscopy and number of miscarriages (r = 0.31; p = 0.02). CONCLUSION: Patients with more than two miscarriages have a high prevalence of uterine cavity abnormalities diagnosed by hysteroscopy; however there are no differences in prevalence or distribution of these lesions related to the number of recurrent miscarriages.